Reflecting their standard dedication to thoughtful and informed debate,
both Democrats and Republicans staged news conferences and pep rallies
on Capitol Hill last week, dragging lab-coated professionals and the
grieving parents of dead children onstage to help promote their own
(while demonizing their opponents') versions of a national "Patients'
Bill of Rights."

President Clinton reinforced the circumspect atmosphere by promising
to veto the GOP version once it reaches his desk (Republicans passed
their version Thursday), thundering that the stingy GOP plan "covers
too few people, provides insufficient patient protections, and contains
inadequate enforcement provisions."

At issue were the Democrats' demands that these new "consumer
protections" -- including a guarantee of emergency room services
and increased access to specialists -- be extended to 160 million Americans,
rather than the Republicans' paltry 48 million, and that decisions as
to what medical care is necessary be returned entirely to attending
physicians (providing they follow "generally accepted medical practice.")

Republicans warned that would destroy the efforts of health care plans
to put a lid on medical costs, bringing back uncontrolled medical inflation
and ultimately causing 1.8 million Americans to lose insurance coverage,
entirely.

(Actually, the Congressional Budget Office estimates the Democratic
plan would have added 4.8 percent to the cost of insurance over five
years, while the GOP version would add 0.8 percent.)

"The Democrat plan means more government, more lawyers, more rules,
more uninsured and more government control," declared Sen. Phil
Gramm, R-Texas. Meantime, across the aisle, millionaire whisky heir
Sen. Edward M. Kennedy, D-Mass. and co-sponsor of the Democratic proposal,
called the GOP version a "profit-protection plan for the insurance
industry."

Needless to say, the dog that never barked in this particular circus
is the one that might have pointed out the U.S. Constitution grants
no authority for the federal government to meddle in the medical market
at all -- that Americans are supposed to be free to contract for the
medical insurance of their choice (if at all), and that national edicts
requiring a gray sameness of "consumer protections" were never
part of the founder's vision of a "small central government, with
limited powers, sharply delineated."

Such quaint notions no longer receive even token attention in Washington,
of course.

So, unfortunately, even the GOP plan will now make it harder for patients
to sue their HMOs -- a further restriction on patient rights, peddled
as part of a "Patient Bill of Rights." How charming.

What "rights" are guaranteed? Both the Republican and Democratic
plans would require that insurers pay for emergency room visits outside
the plan's network when a "prudent lay person" would believe
symptoms indicate a medical emergency. (An insurer would have to pay
for an emergency room visit for chest pains, for example, even if the
pains turned out not to indicate a heart attack.)

That seems reasonable at first glance. But look again. No one has proposed
barring access to emergency rooms, which nearly always treat life-or-death
emergencies without advance payment guarantees. Furthermore, patients
always retain the option of paying such bills themselves. (Would you
allow your favorite politician to condemn your grocer or health insurer
for "conspiring to starve the children" because the grocer
expects to be paid for his produce and the insurance company won't buy
it for you - despite the obvious importance of fruit and vegetables
to your health?)

And why should consumers be banned from buying less expensive policies
that announce up front they will not pay for ER visits that fail to
result in hospital admissions -- a mighty expensive alternative to the
local health clinic?

While patients should certainly have an accessible grievance process,
and retain the right to sue their insurance companies, grisly photographs
and worst-case anecdotes about HMOs denying "life-saving treatment"
-- often referring to expensive experimental treatments for patients
already terminally ill -- ignore the fact that managed care is working
well at holding back costs, which is all that makes medical insurance
affordable for millions, in the first place.

Our medical system, while the best in the world, could stand some reform.
Getting government quickly out of the picture-- except for courts to
prosecute fraud -- would be the best and fastest fix. (Even the "linkage"
of health insurance to the workplace -- the root of the current problem
-- was the direct result of a government intervention, since the 1940s
federal wage freeze allowed employers to compete for employees only
by offering better tax-deductible health insurance -- a tax advantage
never offered the self-employed.)

But failing that, what's required -- if anything -- is minor surgery
under the old guideline: "First, do no harm."

Does anyone really believe that's what we're likely to get, in an atmosphere
of hucksters and carnival barkers maneuvering to savage their Year 2000
opponents with charges they "don't care about dying children"?

Vin Suprynowicz, assistant editorial page editor of the Las
Vegas Review-Journal, is author of the new book, "Send in the
Waco Killers."